When interruptions to sleep become a chronic problem, doctors at the University of Michigan Behavioural Sleep Medicine Program, part of the U-M Sleep Disorders Center, can offer patients a multidisciplinary approach to treating insomnia that teaches them how to sleep.

"Medications are the first line of defense against sleep problems. But when insomnia becomes a chronic problem, there are inevitably patterns of thinking and behaviours that contribute to the ongoing problem that medications cannot address,” Arnedt says.

The Behavioural Sleep Medicine Program uses a three-pronged approach to treatment, which includes using cognitive and behavioural therapy techniques and education. Treatment takes place in an office setting, over four to eight sessions. Each session lasts from 40 to 60 minutes. The treatment takes anywhere from four to six months to complete.

Key to the program's approach is targeting poor sleep habits and maladaptive behaviours that have developed over time and perpetuate insomnia; targeting patterns of thinking that can lead to frustration and worry about one's sleep; and teaching individuals new behavioural strategies.

"We teach people specific behavioural strategies to help them sleep, and how to address the cognitive issues that arise in people who have repeated bad nights of sleep.”

When people repeatedly have difficulty sleeping, they naturally fall into certain patterns of thinking, like worrying if they are going to fall asleep, becoming anxious about their sleep, and even becoming depressed about their sleep, which may perpetuate the problem. Arnedt calls this anticipatory anxiety. "Research shows that these cognitive behavioural therapies provide improvement in 70 percent to 80 percent of patients,” Arnedt says.